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Articles by Tom R. Silbaugh
Showing articles by "Tom R. Silbaugh"
Article
July 2014
The value of point-of-care testing in deteriorating ward patients
Point-of-care testing (POCT) for key laboratory variables may help clinicians assess the level of acuteness and the level of care necessary in the management of deteriorating ward patients.
We used a multibiomarker POCT panel including B-type natriuretic peptide (BNP), D-dimer, myoglobin (Myo), creatine kinase MB...
Cardiac markers
Point-of-care testing
Coagulation/fibrinolysis
D-dimer
Troponins
Natriuretic peptide
Kidneys/fluids
Article
July 2014
Point-of-care testing in the emergency department with emphasis on chest pain patients
The management at the emergency department of patients presenting with symptoms of chest pain and/or acute dyspnea accounts for a substantial proportion of emergency care resources.
In the work-up of these patients the blood measurements of cardiac troponins and brain natriuretic peptides are recommended by current...
D-dimer
Troponins
Natriuretic peptide
Article
May 2014
Laboratory use of umbilical cord blood for critically ill infants
Neonates nearly always experience their single largest day of blood loss on the day of birth due to admission laboratory testing. The term "admission laboratory testing" refers to the initial blood tests done when a baby is born and admitted to the NICU.
Total circulating blood volume in a 3.5 kg term newborn is 280...
Point-of-care testing
Blood gases/acid-base
Hemoglobins
Article
May 2014
Oxygen saturation – better measured than calculated
Ensuring adequate oxygen delivery to tissues is a prime objective of acute/critical medical care. There is no routinely available method for directly monitoring tissue oxygenation; instead clinicians must depend on available indirect measures.
Although not the only factor to be considered, measurement of the amount of ...
Blood gases/acid-base
Article
January 2014
The Role of Cardiac Biomarkers in the Diagnosis and Management of Patients Presenting with Suspected Acute Coronary Syndrome
Reprinted from Ann Lab Med 2013 Sep; 33(5):309-18.
Christenson E, Christenson RH: "The role of cardiac biomarkers in the diagnosis and management of patients presenting with suspected acute coronary syndrome".
Myocardial infarction (MI) is the leading cause of death in the developed world. Biomarkers have an...
Cardiac markers
Troponins
Article
January 2014
Point-of-care blood gas testing decreases ventilator time of the post isolated coronary artery bypass patient
Fast, accurate blood gas testing is a critical component to managing the post isolated coronary artery bypass (ISO-CAB) patient in the hospital intensive care unit/coronary care Unit (ICU/CCU).
Post ISO-CAB patients are admitted to the ICU/CCU after surgery mechanically ventilated. Evidence-based medicine supports...
Process optimization
Point-of-care testing
Blood gases/acid-base
Article
October 2013
Age-adjustment of the D-dimer cut-off value to improve the exclusion of thromboembolic events in older patients
With increasing age, an unspecific rise of fibrin degradation product in blood is observed. Thus, the D-dimer test to rule out thromboembolic events has a high false positive rate in elderly patients.
In 2010, Douma et al introduced a formula to adjust D-dimer cut-off values for age in outpatients >50 years: Age ×...
Coagulation/fibrinolysis
D-dimer
Article
October 2013
Optimizing blood gas testing
Article reprinted with permission from NP Communications LLC/Medical Laboratory Observer, September 2013.
Laboratorians responsible for arterial blood gas testing are focusing on sample integrity, operator safety, data accuracy, and workflow efficiency.
Process optimization
Point-of-care testing
Quality assurance
Blood gases/acid-base
Article
July 2013
A regional program for POCT service to emergency departments – results and remaining challenges
In a regional top-management decision, our laboratory was given the mission to control and quality assure all POCT activities in a regional network of 10 hospitals with emergency units. Based on previous work, new region-wide recommendations, procurements, IT connectivity, services, training, accreditation (ISO...
Process optimization
Point-of-care testing
Blood gases/acid-base
Glucose
Lactate
Creatinine/urea
D-dimer
CRP
Article
June 2013
How to optimize patient flow and outcome in ED - The impact of point of care
Emergency Department (ED) overcrowding is becoming an increasingly international issue.
Although the problem is not only resolved by ED change management (but rather requires a system-wide solution recognizing the complex interdependencies of consumer expectations, human resources, information systems immaturity and...
Point-of-care testing
Process optimization
Blood gases/acid-base
Electrolytes
Cardiac markers
Glucose
Hemoglobins
Bilirubin
D-dimer
Troponins
